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Stenotrophomonas maltophilia

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Stenotrophomonas maltophilia
Stenotrophomonas maltophiliaclinical isolates on MacConkey agar
Scientific classification
Domain:
Bacteria
Phylum:
Pseudomonadota
Class:
Gammaproteobacteria
Order:
Xanthomonadales
Family:
Xanthomonadaceae
Genus:
Stenotrophomonas
Species:
S. maltophilia
Binomial name
Stenotrophomonas maltophilia
Palleroni & Bradbury 1993
Synonyms

Pseudomonas maltophilia(exHugh and Ryschenkow 1961) Hugh 1981
Xanthomonas maltophilia(Hugh 1981) Swingset al.1983
Pseudomonas hibiscicolaMoniz 1963
Pseudomonas betelicorrig. (Ragunathan 1928) Savulescu 1947

Stenotrophomonasmaltophiliais anaerobic,nonfermentative,Gram-negativebacterium.It is an uncommon bacterium andhumaninfectionis difficult to treat.[1]Initially classified asBacterium bookeri,[2]then renamedPseudomonasmaltophilia,S. maltophiliawas also grouped in thegenusXanthomonasbefore eventually becoming thetype speciesof the genusStenotrophomonasin 1993.[3][4]

S. maltophiliais slightly smaller (0.7–1.8 × 0.4–0.7 μm) than other members of the genus. They are motile due topolarflagella,and grow well onMacConkey agarproducing pigmented colonies.S. maltophiliaiscatalase-positive,oxidase-negative (which distinguishes it from most other members of the genus) and has a positive reaction for extracellularDNase.[citation needed]

S. maltophiliais ubiquitous in aqueous environments, soil, and plants; it has also been used inbiotechnologyapplications.[5]Inimmunocompromisedpatients,S. maltophiliacan lead tonosocomialinfections. It is also an emergingnosocomialpathogen associated with opportunistic infections in patients withcystic fibrosis,cancer,andHIV/AIDS.Adherence of this organism to abiotic surfaces such as medical implants andcathetersrepresents a major risk for hospitalized patients.[6]

Pathogenesis[edit]

Gram-stainedS. maltophilia

S. maltophiliafrequently colonizes humid surfaces such as the tubes used inmechanical ventilationand indwellingurinary catheters,as well as medical devices such as suction catheters and endoscopes.[2]Infection is usually facilitated by the presence of prosthetic material (plastic or metal), and the most effective treatment is removal of the prosthetic material (usually acentral venous catheteror similar device).S. maltophiliaadheres strongly and formsbiofilmon plastic surfaces although these abilities may vary greatly between strains. Hydrophobicity was correlated to successful adhesion and biofilm formation on polystyrene surfaces.[7]S. maltophiliafrequently co-occurs and forms multispecies biofilms withPseudomonas aeruginosa.S. maltophiliasubstantially influences the architecture ofP. aeruginosastructures, causing development of extended filaments. These changes arise due to diffusiblesignalling factorencoded byS. maltophilia.[8][9]

The growth ofS. maltophiliainmicrobiological culturesof respiratory or urinary specimens is difficult to interpret due to its low pathogenicity, and is not proof of infection.[2]If, however, it is grown from sites which would be normally sterile (e.g., blood), then it usually represents true infection.S. maltophiliacan be found in the flora of captive snakes.[10]

In immunocompetent individuals,S. maltophiliais a relatively unusual cause ofpneumonia,urinary tract infection,orbloodstream infection;inimmunocompromisedpatients, however,S. maltophiliais a growing source of latent pulmonary infections.[11]S. maltophiliacolonization rates in individuals withcystic fibrosishave been increasing.[12]

Deliberate induction of inflammatory responses is the main pathogenic mechanism ofS. maltophiliainfection.S. maltophiliasecretesouter membrane vesicles(OMVs), that cause an inflammatory response. OMVs fromS. maltophiliaATCC 13637 were found to be cytotoxic to human lung epithelial cells. These OMVs stimulate the expression of proinflammatorycytokineand chemokine genes, including interleukin(IL)-1β,IL-6,IL-8,tumor necrosis factor-αandmonocyte chemoattractant protein-1.[13]

Treatment[edit]

S. maltophiliais naturally resistant to many broad-spectrumantibiotics(including allcarbapenems) due to the production of two inducible chromosomal metallo-β-lactamases (designated L1 and L2).[3][14]This makes treatment of infected patients very difficult.S. maltophiliais ubiquitously present in the environment and impossible to eradicate, which makes prevention also extremely difficult.

Sensitivity testing requires nonstandard culture techniques (incubation at 30 °C).[15][16]Testing at the wrong temperature results in isolates being incorrectly reported as being susceptible when they are, in fact, resistant. Disc diffusion methods should not be used, as they are unreliable, andagar dilutionshould be used instead.[17][18]

S. maltophiliais not a virulent organism and removal of the infected prosthesis is frequently sufficient to cure the infection; antibiotics are only required if the prosthesis cannot be removed. Many strains ofS. maltophiliaaresensitivetoco-trimoxazoleandticarcillin,though resistance has been increasing.[19]It is usually susceptible topiperacillinandceftazidime.[20]Tigecyclineis also an effective drug.Polymyxin Bmay be effective treatment, at leastin vitro,though not without frequent adverse effects.

Epidemiology[edit]

Stenotrophomonasinfections have been associated with high morbidity and mortality in severely immunocompromised and debilitated individuals. Risk factors associated withStenotrophomonasinfection includeHIVinfection, malignancy,cystic fibrosis,neutropenia,mechanical ventilation,extracorporeal membrane oxygenation,central venous catheters,recentsurgery,trauma,prolonged hospitalization, intensive care unit admission andbroad-spectrum antibioticuse.[2][21][22][23][24]

History[edit]

Stenotrophomonas maltophiliahas had multiple different names in the past. It was first found in apleural effusionin 1943 and given the nameBacterium bookeri.It was then renamed toPseudomonas maltophiliain 1961. It was moved to the genusXanthomonasin 1983, and most recently toStenotrophomonasin 1993.[2]

References[edit]

  1. ^Gilligan PH, Lum G, VanDamme PAR, Whittier S (2003). Murray PR, Baron EJ, Jorgensen JH, et al. (eds.).Burkholderia, Stenotrophomonas, Ralstonia, Brevundimonas, Comamonas, Delftia, Pandoraea, and Acidivorax.In:Manual of Clinical Microbiology(8th ed.). ASM Press, Washington, DC. pp. 729–748.ISBN978-1-55581-255-3.
  2. ^abcdeChang YT, Lin CY, Chen YH, Hsueh PR (2015-01-01)."Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options".Frontiers in Microbiology.6:893.doi:10.3389/fmicb.2015.00893.PMC4557615.PMID26388847.
  3. ^abDenton M, Kerr KG (January 1998)."Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia".Clinical Microbiology Reviews.11(1): 57–80.doi:10.1128/CMR.11.1.57.PMC121376.PMID9457429.
  4. ^Palleroni NJ, Bradbury JF (July 1993)."Stenotrophomonas, a new bacterial genus for Xanthomonas maltophilia (Hugh 1980) Swings et al. 1983".International Journal of Systematic Bacteriology.43(3): 606–9.doi:10.1099/00207713-43-3-606.PMID8347518.
  5. ^Berg G, Roskot N, Smalla K (November 1999)."Genotypic and phenotypic relationships between clinical and environmental isolates of Stenotrophomonas maltophilia".Journal of Clinical Microbiology.37(11): 3594–600.doi:10.1128/JCM.37.11.3594-3600.1999.PMC85701.PMID10523559.
  6. ^de Oliveira-Garcia D, Dall'Agnol M, Rosales M, Azzuz AC, Martinez MB, Girón JA (September 2002)."Characterization of flagella produced by clinical strains of Stenotrophomonas maltophilia".Emerging Infectious Diseases.8(9): 918–23.doi:10.3201/eid0809.010535.PMC2732543.PMID12194767.
  7. ^Pompilio A, Piccolomini R, Picciani C, D'Antonio D, Savini V, Di Bonaventura G (October 2008)."Factors associated with adherence to and biofilm formation on polystyrene by Stenotrophomonas maltophilia: the role of cell surface hydrophobicity and motility".FEMS Microbiology Letters.287(1): 41–7.doi:10.1111/j.1574-6968.2008.01292.x.PMID18681866.
  8. ^Ryan RP, Fouhy Y, Garcia BF, Watt SA, Niehaus K, Yang L, et al. (April 2008)."Interspecies signalling via the Stenotrophomonas maltophilia diffusible signal factor influences biofilm formation and polymyxin tolerance in Pseudomonas aeruginosa".Molecular Microbiology.68(1): 75–86.doi:10.1111/j.1365-2958.2008.06132.x.PMID18312265.
  9. ^Dufour N, Rao RP (January 2011)."Secondary metabolites and other small molecules as intercellular pathogenic signals".FEMS Microbiology Letters.314(1): 10–7.doi:10.1111/j.1574-6968.2010.02154.x.PMID21114519.
  10. ^Hejnar, Petr; Bardoň, Jan; Sauer, Pavel; Kolář, Milan (April 2007)."Stenotrophomonas maltophilia as a part of normal oral bacterial flora in captive snakes and its susceptibility to antibiotics".Veterinary Microbiology.121(3–4): 357–362.doi:10.1016/j.vetmic.2006.12.026.ISSN0378-1135.PMID17276020.
  11. ^McGowan JE (June 2006). "Resistance in nonfermenting gram-negative bacteria: multidrug resistance to the maximum".The American Journal of Medicine.119(6 Suppl 1): S29-36, discussion S62-70.doi:10.1016/j.amjmed.2006.03.014.PMID16735148.
  12. ^Waters VJ, Gómez MI, Soong G, Amin S, Ernst RK, Prince A (April 2007)."Immunostimulatory properties of the emerging pathogen Stenotrophomonas maltophilia".Infection and Immunity.75(4): 1698–703.doi:10.1128/IAI.01469-06.PMC1865680.PMID17220304.
  13. ^Kim YJ, Jeon H, Na SH, Kwon HI, Selasi GN, Nicholas A, et al. (November 2016). Carbonetti N (ed.)."Stenotrophomonas maltophilia outer membrane vesicles elicit a potent inflammatory response in vitro and in vivo".Pathogens and Disease.74(8): ftw104.doi:10.1093/femspd/ftw104.PMID27756813.
  14. ^Korotetskiy I, Jumagaziyeva A, Kerimzhanova B, Reva O, Kuznetsova T, Shilov S, Ivanova L, Zubenko N, Parenova R, Iskakbayeva Z, Baimakhanov B, Bekmuhamedova A (2022)."Whole genome sequence data of Stenotrophomonas maltophilia SCAID WND1-2022 (370)".Data in Brief.45:108694.doi:10.1016/j.dib.2022.108694.PMC9679662.PMID36425995.
  15. ^Wheat PF, Winstanley TG, Spencer RC (September 1985)."Effect of temperature on antimicrobial susceptibilities of Pseudomonas maltophilia".Journal of Clinical Pathology.38(9): 1055–8.doi:10.1136/jcp.38.9.1055.PMC499358.PMID4044874.
  16. ^Wilcox MH, Winstanley TG, Spencer RC (March 1994). "Outer membrane protein profiles of Xanthomonas maltophilia isolates displaying temperature-dependent susceptibility to gentamicin".The Journal of Antimicrobial Chemotherapy.33(3): 663–6.doi:10.1093/jac/33.3.663.PMID8040133.
  17. ^Pankuch GA, Jacobs MR, Appelbaum PC (February 1994)."Susceptibilities of 123 Xanthomonas maltophilia strains to clinafloxacin, PD 131628, PD 138312, PD 140248, ciprofloxacin, and ofloxacin".Antimicrobial Agents and Chemotherapy.38(2): 369–70.doi:10.1128/AAC.38.2.369.PMC284459.PMID8192468.
  18. ^Pankuch GA, Jacobs MR, Rittenhouse SF, Appelbaum PC (October 1994)."Susceptibilities of 123 strains of Xanthomonas maltophilia to eight beta-lactams (including beta-lactam-beta-lactamase inhibitor combinations) and ciprofloxacin tested by five methods".Antimicrobial Agents and Chemotherapy.38(10): 2317–22.doi:10.1128/AAC.38.10.2317.PMC284737.PMID7840563.
  19. ^Al-Jasser AM (September 2006)."Stenotrophomonas maltophilia resistant to trimethoprim-sulfamethoxazole: an increasing problem".Annals of Clinical Microbiology and Antimicrobials.5:23.doi:10.1186/1476-0711-5-23.PMC1578578.PMID16978420.
  20. ^Bradley, John (2017).Nelson's Pediatric Antimicrobial Therapy, 23rd edition.AAP.
  21. ^Kwa AL, Low JG, Lim TP, Leow PC, Kurup A, Tam VH (October 2008). "Independent predictors for mortality in patients with positive Stenotrophomonas maltophilia cultures".Annals of the Academy of Medicine, Singapore.37(10): 826–30.PMID19037515.
  22. ^Falagas ME, Kastoris AC, Vouloumanou EK, Rafailidis PI, Kapaskelis AM, Dimopoulos G (November 2009). "Attributable mortality of Stenotrophomonas maltophilia infections: a systematic review of the literature".Future Microbiology.4(9): 1103–9.doi:10.2217/fmb.09.84.PMID19895214.
  23. ^Paez JI, Costa SF (October 2008)."Risk factors associated with mortality of infections caused by Stenotrophomonas maltophilia: a systematic review".The Journal of Hospital Infection.70(2): 101–8.doi:10.1016/j.jhin.2008.05.020.PMID18621440.
  24. ^Mojica MF, Humphries R, Lipuma JJ, Mathers AJ, Rao GG, Shelburne SA, Fouts DE, Van Duin D, Bonomo RA (June 2022)."Clinical challenges treating Stenotrophomonas maltophilia infections: an update".JAC- Antimicrobial Resistance.4(3): dlac040.doi:10.1093/jacamr/dlac040.PMC9071536.PMID35529051.

External links[edit]

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